Annual Report. Covering the period November 2012 to November 2013 (including the 2012/2013 Fiscal Year ending March 31/2013) Vancouver

Transcription

1 Annual Report Covering the period November 2012 to November 2013 (including the 2012/2013 Fiscal Year ending March 31/2013) Vancouver

2 Tel: Fax: Vancouver

3 About the Vancouver Division The Vancouver Division of Family Practice (VDoFP), incorporated on June 24th, 2010, is a not-for-profit society created by and for Vancouver family physicians. Our goals are to improve primary care for our patients and the Vancouver population, and to support family physicians and improve their levels of well-being and professional satisfaction. We have close to 700 practicing family physician and resident members, representing approximately 70% of all family physicians in Vancouver (1000 estimated total). Membership is voluntary and open to practicing family physicians, with or without hospital privileges, who deliver the majority of their services in BCMA District Three (Vancouver). This includes family physicians who work on a sessional, fee-for-service, salaried or other basis, and deliver full services, specialized (obstetrical, ER, hospitalists) services or services at walk-in clinics. Membership also includes resident physicians who contribute fresh and meaningful perspectives on issues in the Vancouver practice region. Our Mission Our mission is to improve the primary care system in Vancouver for the benefit of our patients and members alike through our: Continued Commitment to Vancouver Family Practice Patients We continue to seek ways to address gaps in care and needs that are not being met by the current primary health care system; for example, mental health issues and the transition between in-hospital care and community care. Continued Commitment to Vancouver Family Practice Physicians We continue to support family physicians in improving ways in which they practice medicine in Vancouver: the business aspects of family practice, locum support, opportunities for networking and continuing medical education (CME), and opportunities to address family physician health. Our Strategic Priorities 1. Improve and increase communication: acute, primary, specialists and supports. 2. Improve the system of care: gap identification, reduction of duplication of services and tests, research. 3. Improve member satisfaction, collegiality, and knowledge base: CME, seminars, workshops. 4. Improve and enhance the relationship between family physician and patient: Attachment (A GP for Me). 5. Improve the relationship between the Vancouver Division and critical stakeholders: Vancouver Coastal Health, Ministry of Health, Providence Health Care, Divisions BC and other community partners. Committees and Advisory Groups of the Board Committees of the Board Listed below are the core committees, initiatives and advisory groups established by the Vancouver Division Board of Directors after consultation with members: 1. Attachment (A GP for Me) Vancouver Board of Directors (see page 8) 2. Continuity of Care Committee Dr. Fiona Duncan (Chair), Dr. Rita McCracken (see page 8) 3. Electronic Medical Record Committee Dr. Terence A. Chang (Chair), Dr. James Lai, Dr. Patricia Mirwaldt (see page 9) 4. Membership Committee Dr. Daniel Ngui (Chair), Dr. Piotr Klakowicz (see page 11) 5. Mental Health subcommittee Dr. Patricia Mirwaldt (Chair) (see page 12) 6. Primary Maternity Care Network Committee Dr. James Lai (Chair), Dr. Piotr Klakowicz, Dr. Elena Paraskevopoulos (see page 12) 7. Residential Care Task Force Dr. Margaret McGregor (Chair), Dr. Sue Turgeon (see page 13) 8. Collaborative Services Committee Dr. Terence A. Chang (Chair), Dr. Fiona Duncan, Dr. James Lai, Dr. Patricia Mirwaldt (see page 14) 9. Physicians Data Collaborative Dr. Patricia Mirwaldt (see page 15) Advisory Groups of the Board 1. Communications Committee Dr. Fiona Duncan (Chair), Dr. Elena Paraskevopoulos (see page 17) 2. Executive Committee of the Board Dr. Terence A. Chang, Dr. Rita McCracken, Dr. Patricia Mirwaldt, Dr. John Ridley (see page 6) 3. Finance Committee Dr. John Ridley (Chair), Dr. Terence A. Chang, Dr. Rita McCracken, Dr. Patricia Mirwaldt (see page 19) 4. Strategic Think Tank Dr. Terence A. Chang, Dr. Patricia Mirwaldt (see page 16) Vancouver Division of Family Practice Annual Report 2012/2013 1

4 Message from the Board Chair Over the course of this past year the Vancouver Division has matured in many aspects, ranging from focusing and refining our portfolio work, to building a robust governance model. As we continue to progress our community partners, including Vancouver Coastal Health, Providence Health Care and the Ministry of Health, have become increasingly open to our participation in health care reform and renewal. The Vancouver Division of Family Practice (VDoFP) is the largest Division in the province with our current membership of approximately 700 family physicians and residents members. Together, we actively support and nurture many Vancouver community focused initiatives as well as several provincial initiatives. Without the Vancouver Division, opportunities to deliver our collective voice as family physicians to these initiatives would be limited, if not entirely missed. One of our principal mandates is to provide opportunities for our members to become involved with the planning and delivery of health care in Vancouver. Our objective is to enable family physicians to be a part of the transformation to improve health care delivery in a cost effective and sustainable way. Such a transformation includes impacting the experience of both patients and their providers in the Vancouver practice community. The VDoFP is currently leading several portfolios in the region, one of which focusses on electronic medical records (EMRs) in Vancouver. We envision that through the appropriate use of EMRs, family physicians will be able to practice better medicine. Moreover, EMRs can be used to facilitate efficient communication between physicians in Vancouver. In a similar light, the VDoFP is also working on improving communication and collaboration between family physicians and specialists as we understand the need for tools that will improve communication across community and acute facilities. In the VDoFP s Member Needs Assessment launched this summer, 98% of respondents agreed that the VDoFP s goals align with the purpose of the Division. In keeping with our objective to increase and improve communications in the Vancouver practice region, we have also increased our efforts to communicate with our members. Successful execution of a variety of communication tools, including FastFacts and our Division of Family Practice website, has been received openly by our members as reported through regular feedback and through our recent Members Needs Assessment launched in August of this year. During autumn of 2013, the VDoFP will embark on the Attachment (A GP for Me) initiative which will, once again, provide our members with an opportunity for engagement with fellow colleagues and community partners. Through a comprehensive consultation process, we aim to identify current gaps in care and system inefficiencies. I personally invite you all to become engaged in this important work as the views and expertise of our members helps us to shape our focus and our future direction. The Vancouver Division continues to seek your perspective and encourages each of you to step forward as the rational and practical voice of family practice within Vancouver. Respectfully submitted, Dr. Terence A. Chang Chair 2 Vancouver Division of Family Practice Annual Report 2012/2013

5 Message from the Physician Lead It has been an exciting year for the Vancouver Division of Family Practice (VDoFP). Under the very able direction of our Executive Director - Dr. Dave Baspaly, Chief Operating Officer - Cheryl Hogg, and the excellent professional consultants and staff they have assembled, we have improved our relationship with external partners and moved forward effectively on a number of fronts. Our membership has grown to approximately 700, a testament to the relevance of this work. Working with our Vancouver Coastal Health Authority partner, we have improved access to outpatient mental health services, and we are working with a number of different groups to streamline communication about our patients. We are committed to improving primary care in Vancouver, both for citizens and for the family physicians providing care for Vancouverites. Family physicians understand the need for significant changes in our local primary care system and are ready and willing to offer solutions. Our Board has debated a number of issues and brings a wide variety of perspectives and opinions and a great deal of passion. As members, many of you have attended working meetings and provided your energy and positive suggestions in how to further improve our community. I thank you for that and encourage you to continue to serve with us. FastFacts has been received with a great deal of enthusiasm by our members as a way of keeping you informed about our work and changes within the primary care milieu. As family physicians practicing in the Vancouver region you can play an active part in our work through communicating with any of our Board members, attending working sessions and joining committees. Together we are improving primary care in Vancouver. Regards, Dr. Patricia Mirwaldt, Physician Lead Message from the Vice-Chair Forming a well-established foundation is fundamental to the effective management of any organization. Recognizing this, over the last year the Vancouver Division of Family Practice (VDoFP) Board of Directors has invested considerable effort towards envisioning, creating and executing a new governance model. Centering our work on this new model has skillfully placed the Vancouver Division in a strong position to carry out its mission: to improve the primary care system in Vancouver for the benefit of our patients and members alike. We have formed several key relationships with our community and acute partners. These relationships are essential to galvanizing our work in effective ways. Work ranges from improving the patient journey through continuity of care initiatives, to developing specific resources that will help improve office efficiencies, patient care and the way in which family physicians run their practice. Our most important partner is the community of family physicians practicing in Vancouver. I want to personally acknowledge the family physicians in our region who are now members. Your involvement and expertise are what drive the work of the Division. During our membership campaigns this year, we reached out to you, our colleagues, to encourage you to join and participate with the Division s numerous activities and initiatives. Our efforts resulted in an increase of approximately 200 new members, a testament to the value and prominence of our organization. This is a huge leap, and I can only expect these numbers to grow as we continue on our journey. My enthusiasm for the work of the Division continues to remain steadfast as I see what we have accomplished to date and also see the immense potential in what is to come. It has been my privilege to serve on the Board and it is clear that the VDoFP is a distinguished leader in the Vancouver medical community. As a member and fellow colleague, I encourage you to engage more with your Division and be part of the change in primary care. Regards, Dr. Rita McCracken, Vice-Chair Vancouver Division of Family Practice Annual Report 2012/2013 3

6 Message from the Executive Director Each new year brings a rich mix of challenges and opportunities and 2013 was no exception for the Vancouver Division of Family Practice (VDoFP). Employing a hands-on approach has allowed us to direct resources where they were most needed to meet our strategic priorities. From all reports, we did an exceptional job of solidifying our governance interface, strengthening our services and expanding our membership reach. Overall, as an organization, we ended the year energized, focused and with a strong sense of motivation. We remain steadfastly committed to the principles of the Triple Aim, the value of community care and the importance of the physician/ patient relationship through the principles of Attachment. From a broad perspective, we are confident that our work on behalf of family physicians is being received and appreciated by a multitude of stakeholders throughout Vancouver. Our relationship with our partners and our ability to identify the essential needs of our membership are the major factors that have made the VDoFP a recognized leader. We want to acknowledge Vancouver Coastal Health and Providence Health Care for their ongoing support and commitment to collaboration. The VDoFP is confident that in 2014 we will continue to provide important services to our membership, and by extension, help to improve the system of care within Vancouver. I would like to take this opportunity to personally thank you, our generous and committed members, volunteers and Board members, for your dedication, work and support. With your continued involvement, I am confident we can improve the system of care in Vancouver. Respectfully submitted, Building relationships seems to me the thing I ve gained most out of the Division so far. Both between me and my patients, and me and my colleagues Vancouver Division of Family Practice Member Dr. Dave Baspaly Executive Director 4 Vancouver Division of Family Practice Annual Report 2012/2013

7 Board of Directors Dr. Terence A. Chang Dr. Patricia Mirwaldt Dr. Rita McCracken Members of the Vancouver Division Board of Directors: Dr. Terence A. Chang Board Chair Dr. Rita McCracken Vice-Chair Dr. Patricia Mirwaldt Physician Lead Dr. John Ridley Treasurer Dr. John Ridley Dr. Fiona Duncan Dr. Piotr Klakowicz Dr. Fiona Duncan Dr. Piotr Klakowicz (Resident) Dr. James Lai Dr. Margaret McGregor Dr. Daniel Ngui Dr. Elena Paraskevopoulos Dr. Sue Turgeon Dr. James Lai Dr. Margaret McGregor Dr. Daniel Ngui Staff Dr. Dave Baspaly Executive Director Ms. Cheryl Hogg Chief Operating Officer Ms. Halla Elmobayad Strategic and Program Analyst, Privacy Officer Ms. Ainslie Treleaven Office Manager Dr. Elena Paraskevopoulos Dr. Sue Turgeon Dr. Dave Baspaly Ms. Cheryl Hogg Ms. Halla Elmobayad Ms. Ainslie Treleaven Vancouver Division of Family Practice Annual Report 2012/2013 5

8 Governance and Organizational Structure The Vancouver Division of Family Practice is governed by a Board of Directors comprising of local, practicing family physicians that represent the ideas and opinions of its members. Board Finance Executive CSC Collaborative Services Committee EMR Electronic Medical Record FP Family Practice VCH Vancouver Coastal Health Strategic Think Tank MISSION To improve the primary care system in Vancouver for the benefit of our patients and members alike. Improve and increase communication Improve the system of care Improve member satisfaction, collegiality, and knowledge base Improve and enhance the relationship between member and patient Improve the relationship between the Division and critical stakeholders CSC / Hospitals / Health Authority Residential Care Task Force Membership Committee Mental Health subcommittee Primary Maternity Care Network Committee Information Technology Committee Attachment (A GP for Me) Information/ Communications Membership Benefits Continuity of Care Divisions of FP Interdivisional/ VCH EMR Committee Shared Care Executive EMR User Groups Public Special Interest/ Patient Groups

9 Core Portfolios Attachment (A GP for Me) Attachment (A GP for Me) is an initiative sponsored by the Ministry of Health (MoH) and the BC Medical Association (BCMA) that aims to support family physicians providing longitudinal patient care, support existing physician-patient relationships, and provide access to family physicians for those British Columbians who want one. Designed to create capacity within the existing system, Attachment will provide family physicians with community-level supports and opportunities to become involved in system changes. Since the announcement of Attachment earlier this year, the Vancouver Division of Family Practice (VDoFP) Board of Directors has been strategizing on how to best implement the project into Vancouver s unique and dynamic practice community. Understanding that family physician involvement is integral to the success of health care reform, the Board has developed a comprehensive plan that includes an extensive consultation and engagement process with Vancouver family physicians. Essential elements to set the stage for the execution of the project includes 1) strengthening our relationship with our Vancouver Coastal Health (VCH) and Providence (PHC) partners, 2) developing an approach for involving and engaging family physicians, our health authority partners and citizens of Vancouver, 3) grounding the vision, values and strategy in a published vision and charter, and 4) building a working group composed of member family physicians, with participation from Division sub-committees who already work in areas directly linked to Attachment. Utilizing a community development approach the VDoFP will enable residents, family physicians and partners to engage in a participatory and deliberative process. As part of this process members will be provided with accurate, clear and useful information about the strategy, purpose, and overall benefits of implementing Attachment in Vancouver. Several opportunities for participation with Attachment have been and will be available to members over the course of the next few months. Two of the main ways family physicians are able to participate is by a) registering for Attachment with the VDoFP (which is necessary for billing) and by, 2) billing the new fees that reward stronger primary care relationships and attachment of complex unattached patients. Unified through the Division, family physicians are able to be a part of the change within the primary care system. Such changes can make the system work better for family physicians and patients, thereby improving patient care and improving the practitioner s primary care delivery experience in the Vancouver region. Continuity of Care Committee Committee Members: Dr. Fiona Duncan (Chair), Dr. Rita McCracken, Dr. Joy Russell, Dr. Nardia Strydom, Dr. Joanne Yang Improving the patient s journey through the health care system requires the continued involvement of family physicians, and effective communication between family physicians and patients, specialists and health authorities. Improving involvement and communications has been a primary focus of the Continuity of Care Committee since its inception. The Division s presence as a leader in the Vancouver health community has strengthened substantially, and with this has come an increased demand by health care partners for engagement with the Division in areas related to Shared Care and continuity of care. To ensure that the Committee continues its record of accomplishments as requests for involvement increase, the Committee revised its Terms of Reference that governs the objectives and deliverables. 8 Vancouver Division of Family Practice Annual Report 2012/2013

10 In particular the Committee refined its scope and goals to more clearly define its scope of engagement with partners in the community and around the region. The Continuity of Care Committee also crafted a more refined purpose statement to advocate for family physician involvement throughout the patient s journey of care. This advocacy translates into encouraging ongoing communication between family physicians and specialists, and during acute care admissions and discharge, in order to provide consistent and complete care for patients. Armed with a clear purpose, and with solid goals and deliverables guiding its work, the Committee is now more than ever in a position to deliver successful outcomes in partnership with the community. In addition, the Committee crystallized the process through which it evaluates the many requests for engagement received from community partners. A new document, the Committee Request Assessment Form, is completed by community initiative sponsors and allows the Committee to evaluate each request for Committee involvement through the lens of the Division s priorities. A Dashboard tracks the requests received, ensures alignment between the requests and Committee and VDoFP goals, and details ongoing Committee and Division involvement for requests supported by the Committee. Over the past year the Committee has provided meaningful contributions to a number of initiatives. The Division continues to work with Providence Health Care (PHC) through the Shared Care initiative. The Committee also participates in a number of projects with Vancouver Coastal Health (VCH), including improving family physician access to hospital charts, and on a potential telecommunication project with the Vancouver General Hospital Hospitalists. Over the next year, the Committee will remain involved with both PHC and VCH to ensure the Division s voice is heard and that the value of family physician involvement is understood as a key component to patient care. Through the Division, the Committee continues to move forward as an integral leader in the Vancouver health care community. Electronic Medical Record Committee Committee Members: Dr. Terence A. Chang (Chair), Dr. Eric Cadesky, Dr. Stan Karon, Dr. Sam Krausz, Dr. Angela Lee, Dr. Patricia Mirwaldt, Dr. Damon Ramsey, Dr. Charles Webb Patient care, and subsequently the patient and practitioner experience, is multifaceted with varying factors that impact the quality, timeliness and effectiveness of its delivery. Conscious of this complexity, the Vancouver Division of Family Practice (VDoFP) is involved in many projects aimed to help facilitate the patient journey of care through the Electronic Medical Record (EMR) Committee. In particular, work of the Committee focusses on physician to physician communication, acute to community communication, and sharing of pertinent patient information among practitioners. The Division s focus is to improve the quality of patient care and the clinic experience for both patients and physicians through the proper use of EMRs by addressing the adoption, use and interoperability of EMRs in the Vancouver practice region. The Committee received funding from the Provincial Information Technology Office (PITO) in to develop a multi-vendor EMR Community of Practice (CoP), which is open to all Division members for participation. CoP is vendor-neutral and is inclusive of all clinicians employing EMRs. The aim is to enable family physicians to use EMRs as powerful and efficient tools in the delivery of excellent and efficient health care. This can be achieved through enhancing communications between patient care providers, improving chronic disease management and health promotion activities, improving office efficiency and sustainability, enhancing physician practice quality improvement opportunities, and increasing overall patient safety and satisfaction. Vancouver Division of Family Practice Annual Report 2012/2013 9

11 The primary goals of the CoP are as follows: Establish and support EMR-specific small group learning sessions (EMR User Groups) Develop a curriculum of EMR skills and topics that provide ongoing accredited CME opportunities Continue to lead the projects involving interoperability between differing family physician and specialist community-based EMRs Continue to push the agenda to enable community-based EMRs to communicate with Health Authority information systems Continue the ongoing work to develop a comprehensive e-directory referral resource To date, the VDoFP has established User Groups for the following EMRs: MedAccess (co-leads Dr. Lawson Baird and Dr. Terence A. Chang) IntraHealth Profile (co-leads Dr. Eric Cadesky and Dr. Angela Lee) Wolf (lead Dr. James Lai) User Groups in progress: JanokeMed (lead Dr. Patricia Mirwaldt; group has also been active out of Student Health at UBC) Oscar (took part in their yearly symposium in May) In the VDoFP s Needs Assessment launched this summer, VDoFP was ranked as the #2 preferred Continuing Medical Education provider for family physicians. Moving forward, the Committee will aim to better coordinate the educational objectives and standards of the User Groups (thought a common curriculum) and work with the University of British Columbia s Continuing Professional Development Program to make these User Groups accredited for continuing medical education. The Division has already initiated several learning sessions for all EMR users and non-adopters to better acquaint family physicians with the new GPSC billing codes and integrated EMR functionalities. In the future, an EMR discussion board and User Group calendar will also help strengthen communication between VDoFP members and will highlight future learning opportunities. In addition to developing the CoP and User Groups, the Division s EMR committee, in cooperation with PITO, will prototype the exchange of discrete digital information (beyond PDFs) between family physician-based and specialist-based EMRs (Med-Access and Plexia respectively). Work has begun and will carry on throughout the next year as conversations, negotiations and programming discussions continue to bring this goal to a reality. Furthermore, the VDoFP Board Chair, Dr. Terence A. Chang, is a member of the Information Management and Supporting Technology working group (IMaST), which will help guide the Ministry of Health in evaluating and coordinating all the provincial IT/EMR/other supporting technology projects. Input from the VDoFP will help inform the government on how best to fund these IT projects, which will ideally result in an IT environment that is coordinated and accessible for all family physicians in the province. Through the EMR committee, the VDoFP is interlaced into several key projects in the community and province and will continue to work on behalf of its Vancouver members and family physicians to create a technologically effective, connected and capable practice community. 10 Vancouver Division of Family Practice Annual Report 2012/2013

12 Membership Committee Committee Members: Dr. Daniel Ngui (Chair), Dr. Piotr Klakowicz Soon entering into its fourth year of operation, the Vancouver Division of Family of Practice (VDoFP) has grown substantially since its inception with close to 700 active members to date. Membership continues to grow at a steady pace, a testament to the relevance of the organization and its many family physician and resident members. Members are at the core of the Division shaping the mission, goals and portfolio work the VDoFP partakes in within the Vancouver medical community. Member engagement and communication has been a central focus of the Division since the inaugural Board was formed in 2010 and will continue to be so. The goals of the Committee are to 1) identify and review opportunities for membership recruitment and retention, 2) improve member knowledge base, collegiality, and satisfaction by enhancing member engagement in Division activities, and 3) create accessible and informative resources and opportunities related to membership. During 2013 the Membership Committee considerably increased its efforts towards improving member engagement and communication. As part of this effort the Division sought to increase its public presence and promote consistent messaging that articulates the organization s identity, objectives and successes. The Committee attended several events, hosted booths at various conferences, and launched numerous successful membership drives. Additionally, the Division executed a telephone campaign in which member information was collected and updated. Several membership campaigns were launched over this past year. The Committee reached out to family physicians and family medicine residents in the Vancouver practice area encouraging them to join and educating them about the organization. Through regular member feedback members are expressing their increased interest in participating with Division. Member involvement is vitally important for all Division activities and with the launch of the Attachment initiative over , the Division is seeking member involvement and family physicians are encouraged to participate in any capacity possible. By being a member of the VDoFP, family physicians have access to opportunities that enable family physicians to build relationships, share knowledge, share information and connect with colleagues and other partners in the region. The Vancouver Division s significant size and diverse family physician population presents a unique, yet invigorating challenge, as members of the VDoFP come from various practice types and sub-regions. This diversity creates a richness that is exclusive to the VDoFP, placing the organization and its members in a favorable position. Cultivating and harnessing this diversity through the formation of common goals and interests creates a Division that brings informed and knowledgeable perspectives to health care reform in Vancouver. Membership Certificate Campaign Vancouver Division of Family Practice Annual Report 2012/

13 Mental Health subcommittee Committee Members: Dr. Patricia Mirwaldt (Chair) ), Dr. Bob Bluman, Dr. Pat Howitt, Dr. Rosanna Vellica Lima Collectively with the Collaborative Services Committee (CSC), the Mental Health subcommittee is working to streamline and enhance the mental health system of care in Vancouver and to improve the timeliness and responsiveness of referrals into Vancouver Coastal Health (VCH) Authority mental health programs. In February of this year, the subcommittee surveyed Division members regarding present concerns and experiences with mental health services and brought VCH staff to facilitated group dialogues at a Vancouver Division of Family Practice (VDoFP) Mental Health event. Close to 100 family physician members and key community stakeholders participated in this process. Both engagement levels were designed to critically assess a series of mental health Shared Care models. Division members chose key aspects from working models from several jurisdictions, which resulted in the selection of two promising test models for assessment in Vancouver. The subcommittee continues to work on refining those models with VCH and looks forward to piloting it soon. The Mental Health subcommittee is also a member of the Regional E-Mental Health Steering Committee which is focused on the development of an online E-Mental Health Hub. The hub is designed to offer the public increased access to mental health assessments and services. The Mental Health subcommittee has offered extensive consultation to the Vancouver Adult Mental Health Intake (VAMHI) redesign for their referral process such that Family physicians are routinely notified of the disposition of their referrals and psychiatrists are encouraged to contact family physicians once they have met with the referred patient. The mental health landscape in Vancouver, through the voice and the influence of the Division, is in the process of being improved both for Vancouver citizens and family physicians. Primary Maternity Care Network Committee Committee Members: Dr. James Lai (Chair), Dr. Emily Botting, Dr. Karen Buhler, Dr. Kathleen Cadenhead, Dr. Kim Cottick, Dr. Michael Farmer, Dr. Renee Fernandez, Dr. Kasandra Harriman, Dr. Althea Hayden, Dr. Piotr Klakowicz, Dr. Ashnoor Nagji, Dr. Catherine Reilkoff, Dr. Anna Lizelle Wolak Cultivating an improved and viable referral process among family physicians and maternity care physicians is pivotal to providing appropriate maternity care to patients. Additionally, having access to resources to facilitate information exchange on best practices and knowledge transfer specific to maternity care is a need that has long gone unanswered in the Vancouver practice region. The Primary Maternity Care Network Committee aims to develop referral and knowledge sharing resources for the use of members of the Vancouver Division of Family Practice (VDoFP) and fellow practitioners in the community. Member engagement has been a principal focus of the Committee over the course of Through this engagement, members and Committee members met to plan the development of a referral network for primary maternity care across Vancouver. Member physicians and representatives from Vancouver Coastal Health attended a consultation meeting that identified a series of priorities for the network. These priorities included promotional opportunities, referral platforms and proposed approaches, and knowledge sharing initiatives. As a result of this working session, the Committee submitted a Report with recommendations that stemmed from the rich discussions of the working meeting. Now a regular standing committee of the VDoFP, the Primary Maternity Care Network Committee will proceed to implement these recommendations and create sustainable, effective resources for this work. 12 Vancouver Division of Family Practice Annual Report 2012/2013

14 In the months to come, the Committee will continue to develop a series of practice guides for prenatal and postpartum care, and an Action Plan that will outline the implementation approach for the Committee s recommendations. The Action Plan includes: Cataloguing existing online and offline resources for physicians and the public Defining key messages for maternity care, with a view to develop outreach and engagement programs Developing a physician-to- physician outreach and engagement communications campaign Defining the functional and technical requirements of an online referral network Promoting the sharing of evidence-based best practices across the Division s network Residential Care Task Force Members: Dr. Margaret McGregor (Chair), Dr. Larry Barzelai, Dr. Marla Gordon, Dr. Elena Paraskevopoulos, Dr. Sue Turgeon Providing effective and consistent support to family physicians who work in long term care facilities is important for both physicians and patients. With more than 7,000 frail elderly patients living in long term care facilities in Vancouver, the Residential Care Task Force aims to identify current gaps and develop a community of support for family physicians. This includes mentoring new physicians and identifying systemic barriers to attracting and retaining family physicians. Moreover, the Task Force strives to improve health outcomes and reduce unnecessary hospital transfers for patients in the system. The Residential Care Task Force endeavors to provide opportunities to discuss best practices and tactics for improvements in patient care for physicians working within residential care. Two very successful cross-disciplinary meetings were held that included participants and partners from across the Vancouver practice community. Directors of care, medical coordinators, family physicians, nurse practitioners, and family medicine residents grouped together to address the topics of polypharmacy and the reduction of unnecessary emergency department/ hospital transfers from care facilities. Six Plan, Do, Study, Act (PDSA) initiatives were completed by participants related to the topic of polypharmacy and residential care practice issues. In the VDoFP s Needs Assessment launched this summer, 82% of respondents indicated they want more opportunities to be involved with Division work. Mentoring new physicians interested in residential care facility work and identifying the systemic barriers to attracting and retaining family physicians is an area of focus for the Residential Care Task Force. Recognizing the need to include new family physicians in the dialogue about these barriers and challenges, the Division invited family medicine residents interested in residential care to a key meeting. Resident physicians were given the opportunity to network with physicians working within the field of practice and had meaningful discussions around what it means to practice in residential care and how the system operates. Focused effort is currently being devoted to increasing new graduate interest in residential care and encouraging these new grads to consider working in the field. Recently, the Task Force distributed a reference guide to residential care facilities. This guide informed facilities of the different options that can be taken when seeking new physicians. Additionally, the Task Force is working to formalize locum / rotation opportunities for new grads in the UBC family practice residency program to help with recruitment and retention in the residential practice field. Using data collected from a baseline survey completed by medical directors and directors of care in Vancouver Coastal Health (VCH), the Task Force will begin their work to improve current residential practices and policies. The survey results also provided invaluable feedback on residential care practices and policies in the region, and the exercise demonstrated VCH s support for the Division s work. The Task Force is presently working to develop a framework with VCH to streamline and encourage more collaboration on common projects to improve primary care and will continue to build a strong relationship and partnership. Together with our partners in the community, the Residential Care Task Force is working to better the practice life of member family physicians and improve the patient level of care in residential facilities across Vancouver. Vancouver Division of Family Practice Annual Report 2012/

15 Initiatives in Focus Collaborative Services Committee The Vancouver Collaborative Services Committee (CSC) is the vehicle through which Vancouver family physicians represented by the Vancouver Division, collaborate with partners in the Vancouver primary care system, including Vancouver Coastal Health, the General Practice Services Committee (GPCS: BCMA and Ministry of Health), and Providence Health Care (PHC). The CSC is the forum for discussing issues of concern for patient care outcomes, co-determining priorities and co-designing solutions. Additional representation from patients and others in the community is called upon as needed. The CSC partners are guided in their work by the objectives of the Triple Aim: Improve patient or provider experience of care Improve in population health Create and enable financial sustainability in the system CSC members include: PARTNER NAMES TITLE WITH RESPECTIVE ORGANIZATION Vancouver Division of Family Practice Vancouver Coastal Health Dr. Terence A. Chang (Co-Chair of CSC) Dr. Patricia Mirwaldt Dr. James Lai Dr. Fiona Duncan Mary Ackenhusen (Co-Chair of CSC) Carole Gillam Laura Case Vivian Eliopoulos Board Chair Physician Lead Board Member Board Member Chief Operating Officer Executive Director Primary Care Executive Director Community Health Executive Director Acute Services Providence Health Care Dianne Doyle President and Chief Executive Officer David Thompson Vice President Seniors Care & Clinical Support Services Margot Wilson Director Chronic Disease Management Strategy 14 Vancouver Division of Family Practice Annual Report 2012/2013

16 Physicians Data Collaborative Members: Dr. Patricia Mirwaldt (Treasurer) The Physicians Data Collaborative (PDC) is a not-for-profit organization working to enable the collaborative use of clinical data to improve patient care. Members of the PDC consist of Divisions of Family Practice from across BC. The PDC aims to develop a distributed data network that is trusted through the values of 1) ownership and operation by physicians, 2) protection of privacy and safety for providers and patients and, 3) results that are meaningful to physicians in daily practice. As a founding member and core partner of the PDC, the Vancouver Division of Family Practice (VDoFP) has invested a total $260,000 over the past three years, making the VDoFP the largest PDC funder to date. In the VDoFP s Member Needs Assessment launched this summer, members indicated the need for more learning opportunities related to using technology in their practice to enhance patient care. Granting family physicians access to readily available data to answer clinical questions has great utility in the practice setting. The Division anticipates that, through the PDC, physicians will be able to quickly and discreetly retrieve health data, giving them the ability to deliver more effective and informed care. In turn, the patient and practitioner experience will be enhanced leading to a better patient journey and an increased sense of professional satisfaction for family physician members delivering primary care. Given the vast size of the practice region in Vancouver, the VDoFP recognizes the potential benefits of having access to a unified data network. Once fully launched, this centralized data source can assist Division members in the identification of local data trends through combined datasets. Such information will enable family physicians to better understand their patients throughout the Vancouver practice region. When fully functional, the data network will also assist the VDoFP by providing local data to support local health care initiatives, continuous learning, and clinical research. Furthermore, the distributed data network will make data collection and analysis efficient, thereby enabling a tight feedback loop to support quality improvement using Plan, Do, Study, Act (PDSA) cycles. Vancouver Division of Family Practice Annual Report 2012/

17 Strategic Think Tank ORGANIZATION MEMBER TITLE WITH RESPECTIVE ORGANIZATION Vancouver Division of Family Practice Dr. Terence A. Chang Board Chair Vancouver Division of Family Practice Dr. Patricia Mirwaldt Physician Lead Powell River Division of Family Practice Dr. Bruce Hobson Lead Physician Richmond Division of Family Practice Dr. Jack Kliman Board Chair North Shore Division of Family Practice Dr. Dean Brown Board Chair Divisions of Family Practice are physician-led, communitybased networks of family physicians that work together to identify primary care system gaps in their communities. Through this identification, Divisions aim to develop programs that support professional practice and local patient care needs. Understanding that the Vancouver Division of Family Practice (VDoFP) is one part of a collective health care community, the VDoFP has formed a Strategic Think tank that brings together Division partners from other practice areas to discuss common topics and issues. Members of the group come together to identify and develop initiatives and positions that will assist Divisions when interfacing with key community partners. These partners include government and its agencies, health authorities and other organizations that work in or are related to the primary health care system. Moreover, the Strategic Think Tank works to identify structural issues that are critical to the Division s interests, while formulating informed, meaningful, and transparent responses to issues that are local and inter-divisional in nature. The forum is used to bring topics to the table that impact both the VDoFP and other regional Divisions in the lower mainland. Through this forum, the VDoFP strives to strengthen and further community and regional understanding of Divisions through the sharing of interdivisional information. Divisions are made by and for family physicians across British Columbia and represent their opinions and interests on many fronts. Solidifying the understanding and expectation that the Divisions of Family Practice is the go to place for information on family practice is a core focus of the Strategic Think Tank. Collectively, the regional Divisions are able to tactfully send out messaging and positions on a variety of issues that, in essence, will shape changes to the primary care system in Vancouver and British Columbia. 16 Vancouver Division of Family Practice Annual Report 2012/2013

18 Membership Engagement & Communication FastFacts The Vancouver Division of Family Practice (VDoFP) is committed to sharing valuable and relevant information with its membership. Through this commitment, the VDoFP sought to create an open and inviting virtual space that encourages VDoFP members and partners to approach the Division with opportunities and information. Efforts resulted in the creation of a bi-weekly communications tool to share information, titled FastFacts. This electronic communication medium includes: What s happening in the Vancouver Division right now Section provides education on hot items in the Division and is used to educate members on the benefits of membership Opportunities for skill building and/or contributing a family physician perspective Section provides valuable opportunities for community involvement and skill-building events from the VDoFP and/or partners and/or members CME/ education/ collegial events Section provides information on VDoFP-led CME/ education/ collegial events and/or partner-led CME/ education/ collegial events Research requests and opportunities Section provides information on industry-free, ethics approved research that is vetted for relevance Useful information for your practice Section provides FYIs, community resources/services, and other tools to help support family physicians from the VDoFP and/or partners and/or members I think FastFacts is a great tool for communication. I often take something from each edition. VDoFP Member Requests are vetted by the Division s Communications Committee to ensure that the information shared is relevant and valuable for members. Members and partners are directed to read the Division s Consultation Policy, which was created by the Committee to provide guidelines to requesters. FastFacts is now a popular tool as acknowledged by our members and partners alike and is the go to place for information, resources and opportunities. We encourage VDoFP members and partners to submit requests and participate in this knowledge and information exchange for the betterment our members and patients alike. 93% of the Needs Assessment respondents regularly read FastFacts. Vancouver Division of Family Practice Annual Report 2012/

19 Doctors Den As an association representing Vancouver family physicians and residents, it has been identified that an effective mechanism is needed to foster member-initiated innovation and creative ideas that will help the Division meet its strategic objectives. To achieve this goal in an engaging way, the Board has elected to develop a live forum that will allow Vancouver family physicians and residents to pitch small projects for funding consideration. In essence, this forum establishes an interactive two-way communication and dialogue interface between the Board and a Vancouver family physician or resident with an innovative/creative idea. The VDoFP Doctors Den offers a unique opportunity for members to discuss key issues and their implications, and to pitch practical projects directly to the VDoFP Board for funding consideration. Approved member applications to date: Dr. Eric Cadesky MeKeeper: the accurate, secure and mobile patient health record Dr. Lesley Horton The Power of Feeling Your Best presenting leading edge tools on how to live a happier, healthier, more balanced life Dr. Colleen Kirkham Sexual Health Education Lunches: a pilot project to create a liaison between community family physicians and their local high school(s) Dr. Daniel Ngui The Vancouver Divisions of Family Practice FP Clinical Drop Box. The Quintessential Family Practice Tool for the Next Century Dr. Ellen Wiebe Telemedicine for city doctors: Seeing family practice patients by Skype (A pilot project) 18 Vancouver Division of Family Practice Annual Report 2012/2013

20 Message from the Treasurer What a long way we have come. I reflect back to three years ago when a small group of dedicated and motivated family physicians breathed life into the notion of our own local Division of Family Practice. I could not have imagined the growth we have achieved today. A series of meetings that began as far back as 2009 has culminated into a group of close to 700 members who stand together and truly represent the family physicians of Vancouver. Together, we now have a strong voice to bring our unique and central point of view to the table to advocate for our patients and shape the delivery of care in Vancouver. Up to now, the Ministry of Health, the BCMA and Vancouver Coastal Health have formed the model of health care in our city without unified input from us, the front line physicians who deal directly with the ongoing needs of our patients. Drawing from our collective wisdom, gained through our daily experience of how the failings of our current system frustrate both us and our patients, we are now strong leaders and partners in building better health care in our home town. Right from the inception of our inaugural Division Board, I have had the privilege of being your treasurer. I cannot help but be very proud of how this role has matured in such a relatively short time. The treasurer s portfolio has risen from its humble beginning as a home-based accounting clerk and financial do-all to the true Board steward of a busy million dollar non-profit society that it is today, replete with professional staff support and a rigorous system of financial controls and accounting. The many initiatives and activities underway in our Division have demanded a more robust financial department to manage the increased complexity without losing oversight, and we have met the challenges at every step. In looking at our Annual Report financial statements, it is my hope that the excellence of our financial stewardship is evident. Looking forward I see a great deal of development and maturity that has yet to come, and that is very exciting. As an organization we are well beyond our infancy, but not far beyond our adolescence. Our primary goal is to provide strong, local family physician leadership in guiding health care delivery in Vancouver and we now have all the tools to achieve this, but we continue to learn how to most effectively and efficiently use them. Concurrently, we continue to build relationships with our partners based on mutual respect, trust, and hopefully some common sense. Combining these new relationships, solid financial support, and an active, engaged membership, one cannot help but be excited about the possibilities for an improved system of healthcare delivery in Vancouver, and the Vancouver Division as one of the key drivers of that improvement. As in years past, I hope that our successes to date may inspire you to join and become active in our journey. Best Personal Regards, John Ridley, MD, CCFP, Treasurer Assets 2012/2013 Expenses 2012/2013 Revenue 2012/2013 Term Deposit $10,000 Accounts Receivable $1,803 HST Receivable $19,755 Prepaid Expenses and Deposits $9,903 Property and Equipment $13,339 Cash $631,723 Amortization & Loss on Disposal of Assets $ Facilities Costs $41,611 Marketing and Communications $35,747 Administrative Costs $61,607 Physician Payments - Board, Committees & Events $274,938 Meeting Costs and Events $48,436 Grants $2,928 Committee Support $33,691 Physician's Data Collaborative $130,000 Human Resources $190,011 Infrastructure Grant 100% Other Revenue 0% Infrastructure Grant Other Revenue *Complete audited financial statement are available upon request. Vancouver Division of Family Practice Annual Report 2012/

21 Major Events JANUARY Board Strategic Planning Retreat Residential Care Event EMR User Group Meetings FEBRUARY MARCH HIV CME Session Membership Campaign Mental Health Survey Mental Health Event Membership Campaign Maternity Care Event Attachment Event EMR User Group Meetings APRIL Residential Care Event MAY EMR User Group Meetings JUNE Provincial Roundtable JULY AUGUST Membership Campaign Member Needs Assessment Residential Care Survey EMR User Group Meetings Membership Campaign Certificate Campaign Open House Event Member Needs Assessment SEPTEMBER OCTOBER NOVEMBER HIV CME Session Complex Billing/Attachment CME Sessions Board Nominations Residential Care Survey UpToDate Webinar EMR User Group Meetings Residential Care Event Board Nominations UpToDate Webinar Complex Billing/Attachment CME Sessions Annual General Meeting HIV CME Session 20 Vancouver Division of Family Practice Annual Report 2012/2013